Surgery – Diagnostic testing – Detecting nuclear – electromagnetic – or ultrasonic radiation
Reexamination Certificate
2001-01-23
2003-08-19
Jaworski, Francis J. (Department: 3737)
Surgery
Diagnostic testing
Detecting nuclear, electromagnetic, or ultrasonic radiation
Reexamination Certificate
active
06607487
ABSTRACT:
BACKGROUND OF THE INVENTION
1. Field of Endeavor
The present invention relates to surgery, and in particular relates to precise location of an implant during surgery.
2. State of Technology
A report by the Office of Medical Applications of Research of the National Institutes of Health states that more than 120,000 artificial hip joints are being implanted annually in the United States. Successful replacement of deteriorated, arthritic, and severely injured hips has contributed to enhanced mobility and comfortable, independent living for many people who would otherwise be substantially disabled. New technology involving prosthetic devices for replacement of the hip, along with advances in surgical techniques, has diminished the risks associated with the operation and improved the immediate and long-term outcome of hip replacement surgery.
Primary total hip replacement (THR) is most commonly used for hip joint failure caused by osteoarthritis; other indications include, but are not limited to, rheumatoid arthritis, avascular necrosis, traumatic arthritis, certain hip fractures, benign and malignant bone tumors, the arthritis associated with Paget's disease, ankylosing spondylitis, and juvenile rheumatoid arthritis. The aims of THR are relief of pain and improvement in function.
Improvement can still be made however, concerning prosthetic and operating designs and materials that are most effective for specific groups of patients and which surgical techniques and rehabilitation approaches yield the best long-term outcomes. Issues also exist regarding the best indications and approaches for revision surgery.
PCT publication WO 99/59487, titled An Acetabular Total Hip Component Alignment System for Accurate Intraoperative Positioning in Inclination, by William A. McGann, published Nov. 25, 1999, provides the following description: “An alignment system is used for alignment structure for surgical procedures. The alignment system and method can be used in a preferred embodiment to align an acetabular cup implant for purposes of a hip replacement procedure. The alignment system and method can be used for other alignment procedures whether or not an implant is utilized.
U.S. Pat. No. 6,002,859, titled Apparatus and Method Facilitating the Implantation of Artificial Components in Joints, to Michael K. Blackwell, Anthony M. DiGioia III, Branislav Jaramaz, Takeo Kanade, Frederick M. Morgan, Robert V. O'Toole, and David A. Simon, assigned to Carnegie Mellon University, patented Dec. 14, 1999, provides the following description: “Apparatuses and methods are disclosed for determining an implant position for at least one artificial component in a joint and facilitating the implantation thereof. The apparatuses and methods include creating a joint model of a patient's joint into which an artificial component is to be implanted and creating a component model of the artificial component. The joint and artificial component models are used to stimulate movement in the patient's joint with the artificial component in a test position. The component model and the joint model are used to calculate a range of motion in the joint for at least one test position based on the simulated motion. An implant position, including angular orientation, in the patient's joint is determined based on a predetermined range of motion and the calculated range of motion. In a preferred embodiment, the implant position can be identified in the joint model and the joint model aligned with the joint by registering positional data from discrete points on the joint with the joint model. Such registration also allows for tracking of the joint during surgical procedures. A current preferred application of the invention is for determining the implant position and sizing of an acetabular cup and femoral implant for use in total hip replacement surgery.”
U.S. Pat. No. 5,769,092, titled Computer-aided system for revision total hip replacement surgery, issued Jun. 23, 1998, to Willie Williamson, Jr., assigned to Integrated Surgical Systems, Inc., provides the following description: “computer implemented systems and methods for removing bone cement or other material to replace a bone prosthesis is provided. A computer aided method of replacing a bone prosthesis according to the present invention comprises the steps of: receiving as input image data of a bone; identifying bounding contours of material in the image data surrounding a first bone prosthesis for removal; and generating system contours from the bounding contours, the system contours specifying a cavity to be cut in the bone to accommodate a second bone prosthesis.”
U.S. Pat. No. 5,402,801, titled System and method for augmentation of surgery, issued Apr. 4, 1995, to Russell H. Taylor, assigned to International Business Machines Corporation, provides the following description: “The system and method includes a manipulator for manipulating a surgical instrument relative to a patient's body and, a position sensor for sensing the position of the surgical instrument relative to the patient's body. The manipulator can be manually or computer actuated and can have brakes to limit movement. In a preferred embodiment, orthogonal only motion between members of the manipulator is provided. The position sensor includes beacons connected to the patient and manipulator or surgical instrument and, a three dimensional beacon sensor adapted to sense the location and position of the beacons. Redundant joint sensors on the manipulator may also be provided. The system and method uses a computer to actively interact with the surgeon and can use various different input and output devices and modes.”
U.S. Pat. No. 4,404,692 for a centering system for hip replacement, by Nas S. Eftekhar, patented Sep. 20, 1983, provides the following description: “The present invention provides a system for centering proximally and distally a hip replacement. The system comprises a trial hip prosthesis for centering proximally the hip replacement and a device adapted for insertion into the medullary canal for centering distally the hip replacement, the device being provided with means to receive and center the stem in the hip replacement. A method for obtaining a proximally and distally centered total replacement is also provided.”
SUMMARY OF THE INVENTION
A system for assisting in precise location of an implant during surgery. The system uses ultrasound imaging for guiding the placement and orientation of the implant. The target area is interrogated using ultrasound. Reference points are marked relative to the target area. The reference points are used to locate the implant in the target area. Additional aspects, advantages, and features of the invention are set forth in part in the following description. Various aspects, advantages, and features of the invention will become apparent to those skilled in the art upon examination of the description and by practice of the invention.
REFERENCES:
patent: 4404692 (1983-09-01), Eftekhar
patent: 5086401 (1992-02-01), Glassman et al.
patent: 5402801 (1995-04-01), Taylor
patent: 5769092 (1998-06-01), Williamson
patent: 5879301 (1999-03-01), Chiabrera et al.
patent: 6002859 (1999-12-01), DiGioia et al.
patent: 6256529 (2001-07-01), Holupka et al.
patent: 6370418 (2002-04-01), Bernoski
patent: 6385475 (2002-05-01), Cinquin et al.
patent: 6413215 (2002-07-01), Wu et al.
patent: 6425865 (2002-07-01), Salcudean et al.
patent: WO 99/59487 (1999-11-01), None
Chang John
Haddad Waleed
Kluiwstra Jan-Ulco
Matthews Dennis
Trauner Kenneth
Jaworski Francis J.
Patel Maulin M
Scott Eddie E.
The Regents of the University of California
Thompson Alan H.
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